Individual provider Active NPI

Oksana Berkovich, MD

  • Internal Medicine Physician
  • Bronx, NY
National Provider Identifier
1245291269
Registry record updated Nov 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
214624 Issued in NY
Practice address
2190 Boston Rd Apt 1N
Bronx, NY 10462-1217
Phone
(718) 863-8663
Fax
(718) 863-8261
NPI assigned
Mar 29, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 5, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 214624 NY Primary

Addresses

Primary practice location

2190 Boston Rd Apt 1N
Bronx, NY 10462-1217

Mailing address

31 Amanda Lane
New Rochelle, NY 10804
Phone (718) 863-8663

Other identifiers 1

IdentifierTypeStateIssuer
02184201MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040512001667 NY Practitioner - Internal Medicine 2961492954 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Albert Einstein College of Medicine of Yeshiva University, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oksana Berkovich Medical PCGroup PAC ID 6103831029, 2 clinicians

Practice addresses (Care Compare)

2190 Boston Rd
Apt 1N
Bronx, NY 10462-1217
Phone (718) 863-8663

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Boston Road Medical Practice PC Internal Medicine CurrentSince Mar 21, 2005 Accepting new patients
Oksana Berkovich Medical PC Internal Medicine CurrentSince Mar 14, 2005 Accepting new patients

Locations

2190 Boston Rd
Apt 1N
Bronx, NY 10462
Phone (718) 863-8663

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1143590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257379200000",
    "number": "1245291269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 AMANDA LANE",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "10804",
            "telephone_number": "718-863-8663",
            "fax_number": "718-863-8261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2190 BOSTON RD APT 1N",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104621217",
            "telephone_number": "718-863-8663",
            "fax_number": "718-863-8261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERKOVICH",
        "first_name": "OKSANA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-29",
        "last_updated": "2009-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "214624",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02184201",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.